Echoes from a Far

Despite my grr-hate last entry on Monday, I really really like Anesthesia. Its so much fun for me everyday minus the drama. This week I am in Parkland OB-Anesthesia and I find the residents and attendings in the Ob-Anesthesia dept are really enjoyable people to work with. But you may ask how so? Didn't you spend an entire blog entry griping? Well in contrary to its own location and entitiy, most of UTSW Anesthesia is made of up of of residents from other Tx med schools and out of state schools, very few actual UTSW grads are actually in the UTSW residency program. They are actually really personable. They work really hard but spend alot of time but our down time is really getting to know each other ie Residents with attendings and residents with med students, attendings with medstudents.

Today I got to do 2 successful spinal anesthesia blocks in women who were getting Bi-Tubal ligations. It was quite satisfying to do something successfully. What is a spinal anesthesia how is different from an epidural? Well spinal block is done at the L3-L4, level. Using iliac crests with landmarks find the space between spinous processes to mark and insert your needle. Once you find ur location, you numb the area with Lidocaine, insert a guide needle into the spinous process space ( ie gap), and then puncture the dura, thread a very fine wire into the dural space and watch the CSF flow out of the needle and then inject in your fentanyl and buvicane into the space. An epidural consists of the same general process of a spinal block except you have a continuous thin tube hanging out of your back and available to the Anesthesioloists when they need to inject more Fentanyl.

So after lectures, all the visiting med students go and eat lunch together down in the cafeteria. So as we were walking down a student from Tech mentioned how he was getting brushed off and can't really find residents or an attending to tag along with since all the UTSW kids get to all the attendings and best residents early. He was like man, UTSW kids know where the attendings are at all times. You may ask why do u need to stick to an attending? Well anes is a really procedure and hands on oriented type of work. If you are NOT able to find a patient, teaching oriented attending : A) you may never get to do any type of procedures ie Intubation and lines ect B) you will not learn good technique and form and C) lastly build a relationship with an attedning to obtain rec letters from. So as this Tx Tech student (guy) was telling me his brush off stories, it was basically the same experience I and another visiting med student had our first week. Might I say I heard my own echo?

So this place as far as the Med school goes is really not a lets be nice and help each other out type of environment (I have to point out the residents are the opposite of the students). Take for the example that some of the UTSW kids have already over 15 intubations and a multitude of procedures under their belt but US visiting students ( and more and more visiting students are realizing the discrepency in treatment between Us and UTSW kids) have barely gotten in 2 (me) They do not share nor do they offer help. They are neither nice nor or they outrightly mean. Its a medium of unspoken "your on my territory. "

However at least I have another UNT person with me, we do at least point out to eachother the nice attendings and take turns doing procedures since we are on the same OB-anesthesia schedule. What's the point of this craziness- in hogging every thing? My philosophy: I know i'm going to learn all the "stuff" ie intubation and crap during intern year why not just have a good time, joke, and find an attending to notice me and get a letter and finally say "Peace out, I outta here".